Evaluation of 13-valent pneumococcal conjugate vaccine and concomitant meningococcal group C conjugate vaccine in healthy infants and toddlers in Spain
Por:
Diez-Domingo, J, Gurtman, A, Bernaola, E, Gimenez-Sanchez, F, Martinon-Torres, F, Pineda-Solas, V, Delgado, A, Infante-Marquez, P, Liang, J, Giardina, P, Gruber, W, Emini, E, Scott, D and 501 Study Grp
Publicada:
4 nov 2013
Resumen:
Background: Given the concurrent administration of multiple vaccines during routine pediatric immunizations, efforts to elucidate the potential interference of any vaccine on the immune response to the concomitantly administered antigens are fundamental to prelicensure clinical research.
Methods: This phase 3 randomized controlled trial of 13-valent pneumococcal conjugate vaccine (PCV13) versus 7-valent PCV (PCV7) assessed immune responses of concomitantly administered meningococcal group C conjugated to diphtheria toxin cross-reactive material 197 (MnCCV-CRM197) in a 2-dose infant series and 15-month toddler dose.
Results: 619 subjects were randomized, 315 to PCV13 and 304 to PCV7. MnCCV-CRM197-induced immune responses were similar between the PCV13 and PCV7 groups, with >97% of the subjects achieving a >= 1:8 meningococcal serum bactericidal assay (SBA) titer after both dose 2 and the toddler dose. Geometric mean titers were lower in the PCV13 group 191.22 (167.72, 218.02) versus 266.19 (234.86, 301.71) following dose 2 and 432.28 (361.22, 517.31) versus 730.84 (642.05, 831.91) following the toddler dose. The geometric mean (GM) meningococcal SBA titer ratios (PCV13/PCV7) were 0.72 after dose 2 and 0.59 after the toddler dose. The criteria for MnCCV-CRM197 non-inferiority for GM titers were satisfied after dose 2. Percent responders was similar up to titers of 1:128. PCV13 elicited substantial antipneumococcal responses against all 13 serotypes, with >= 90% of the subjects achieving an antibody concentration >= 0.35 mu g/mL after dose 3 in the infant series. Safety and tolerability were similar between the vaccine groups.
Conclusions: Immunogenicity results of MnCCV-CRM197 for PCV13 compared with PCV7 included lower GMTs, but the clinical significance of this is unknown as the proportion of infants achieving protective MenC antibody titers was comparable in the two groups. Percent responders were similar up to titers of 1:128. PCV13 has an acceptable safety profile in infants and toddlers, while providing expanded coverage against pneumococcal disease. (C) 2013 Elsevier Ltd. All rights reserved.
Filiaciones:
:
CSISP, Valencia 46020, Spain
Gurtman, A:
Pfizer Inc, Pearl River, NY USA
Bernaola, E:
Hosp Virgen del Camino Pamplona, Pamplona, Spain
Gimenez-Sanchez, F:
Hosp Torrecardenas, Almeria, Spain
Martinon-Torres, F:
Hosp Clin Univ Santiago de Compostela, Santiago De Compostela, Spain
Inst Invest Sanitaria Santiago, Vaccine Res Unit, Santiago, Spain
Delgado, A:
Hosp Torrelodones, Madrid, Spain
Infante-Marquez, P:
Clin Virgen del Mar, Almeria, Spain
Liang, J:
Pfizer Inc, Collegeville, PA USA
Giardina, P:
Pfizer Inc, Pearl River, NY USA
Gruber, W:
Pfizer Inc, Pearl River, NY USA
Emini, E:
Pfizer Inc, Pearl River, NY USA
Scott, D:
Pfizer Inc, Pearl River, NY USA
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